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Gastroenterology Coding Alert

CPT® 2015 Part 2:
New Lower GI Endoscopy Changes Echo the Upper GI Endoscopy Changes From Last Year
You’ll reduce the amount of times you use modifier 52 for GI procedures. If you ... Read more
CMS Unveils 4 New Modifiers to Offset Unwarranted Use of 59
Judicious selection and not playing safe will be the key terms for future. Popularity ... Read more
ICD-10 Update:
Correct Complication Choices Will Conquer Ulcerative Enterocolitis Coding Obstacles
Get ready to learn changed disease terminologies. As the transition date to ICD-10 com... Read more
Readers Question:
Reporting Laser Tumor Ablation is Easier Than You Thought
Question: We encountered a colonoscopy patient recently who required a laser tumor ... Read more
Reader Question:
Check CCI Edits Before Billing Control of Bleeding
Question: Our physician just performed an EGD with biopsy and control of bleeding f... Read more
Reader Question:
Prove Medical Necessity for Unlisted Procedure Claims
Question: One of our physicians performed a colonoscopy on a Medicare patient with ... Read more
Reader Question:
Reporting Clip Placement as Separate Code is a Surefire Way to Trouble
Question: Our GI recently performed a colon polyp removal with a hot snare. Resecti... Read more
You Be the Coder:
Don't Get Vexed by Variceal Treatment
Question: What methods can gastroenterologists use to treat esophageal and gastric ... Read more
CPT® 2015 Part 1:
Non-Incisive Diverticulitis Drives New Esophagoscopy Changes
Bipolar cautery description gets a boot out of 43216 descriptor. This year, you saw a ... Read more
Fine Tune Your Flexible Sigmoidoscopy Reporting With These 4 Tips
Order of codes presented in the claims makes a significant difference. Although Medica... Read more
Don't Let Poor Paperwork Come In the Way of Deserved Payouts
Get ready for even more specificity in ICD-10 next year. You may be able to choose dia... Read more
ICD-10 Update:
Malignant Esophageal Tumor Makes Your Reporting Easier Next Year
This update bucks the trend of expanding into multiple codes. Here’s a surprise:... Read more
Readers Query:
Control of Bleeding Takes Precedence in Colonoscopy
Question: Our GI just performed a colonoscopy on a Medicare patient for control of ... Read more
Reader Query:
Pay Heed to Payer Inputs for Smooth Payouts
Question: A patient had an EGD with injection and the provider used bicap cautery t... Read more
Reader Query:
History Matters When Reporting Screening Codes for Medicare
Question: We encountered a patient with a history of polyps. She is due for a surve... Read more
You Be the Coder:
Identify Biopsy Location for Accurate EGD/EUS Reporting
Question: We had a patient who underwent an EGD as well as an EUS. After our physic... Read more
Steer Clear of the Multiple-Endoscopy Limitations With These Pointers
Don’t get confused between multiple-procedure and multiple-scope rules. If you&r... Read more
Fee Schedule:
Your Best Path to Deserved Reimbursement Goes Through RVU method
Look for differences in local and national rates to avoid rejection. The Medicare Phys... Read more
ICD-10 Update:
Appendicitis Coding Remains Painless After Changeover
Other diseases of appendix get more accuracy from next year. Think of a gastroenterolo... Read more
CMS Unveils 4 New Modifiers to Offset Unwarranted Use of 59
Judicious selection and not playing safe will be the key terms for future. Popularity ... Read more
Readers Question:
Presence of Earlier PEG will Decide PEJ Coding
Question: Our Gastro conducted a placement of a PEJ tube on a patient who already had a ... Read more
Reader Question:
Double Check Documentation for Type of Pouchitis
Question: One of our patients has been diagnosed with pouchitis. Which ICD-9 code s... Read more
Reader Question:
Accurate Number of Points Will Lead You to Accurate MDM Level
Question: Our gastroenterologist attended to a patient and noted the following: A... Read more
Reader Question:
Don't Ignore Anemia as a Precursor for Colonoscopy
Question: Can I use the diagnosis of iron deficiency anemia for a colonoscopy? The ... Read more
You Be the Coder:
Show Necessity for Multiple Polyp Removal Codes
Question: Recently, our gastroenterologist removed three polyps during a colonoscop... Read more
Bust 3 Myths to Recoup the Maximum ERCP Reimbursement Your MD Ethically Deserves
If you’re relying only on modifiers 51 and 59, you could be missing out. If you&... Read more
Keep These GERD Testing Options at Your Fingertips
Reporting multiple tests in one day will not get you in trouble. According to estimate... Read more
Get Ready for Location Specificity in Reporting Crohn's Disease
Be sure to denote the complications or lack thereof in your fifth and sixth digits. As... Read more
Readers Question:
Modifier 78 is Your Friend for Post-Procedure Visits
Question: A Medicare patient returned to the endoscopy lab at 4 p.m. to control a b... Read more
Readers Question:
Justify Pre-operative Evaluation Billing with Accurate Diagnoses
Question: The general surgeon has asked us to determine whether one of our establis... Read more
Reader Question:
Paperwork Must Back Up 91035 Claim
Question: Our providers bill for the interpretation of the Bravo with 91035/26. The... Read more
You Be the Coder:
Make Best Use of Modifier 53 for Discontinued EGD Procedures
Question: Our GI performed a placement of naso-jejunal tube through the nose? Is CP... Read more
Follow These 4 Rules to Make Hemorrhoid Coding a Painless Affair
Type and precise method of treatment are keys to reimbursement heaven. Although hemorr... Read more
Debug Your Dysphagia Coding By Focusing on Type
Knowing the phase of the condition will point you in the right direction. You have to ... Read more
These Colonic Polyp Codes will Come in Handy in 2015
Distinguishing between non-neoplastic and neoplastic polyps will save your bacon. Next... Read more
Remove All Obstacles From Submitting a Perfect Foreign Body Removal Claim
Even dislodging the foreign body deserves a code. The way your coding progresses in ca... Read more
You Be the Coder:
Be Careful of Modifiers in Co-opted GI Procedures
Question: Our pediatric gastroenterologist scheduled a patient for an EGD with biop... Read more
GI Tube:
Target These Tube Placement, Replacement, and Maintenance Codes for a Picture Perfect Claim
Keep a sharp eye out for type of tube, kind of placement and inclusion of fluoroscopic g... Read more
Don't Let Possible Level 4 and 5 E/Ms Opportunities Slip by With These Crucial HPI Facts
Resolve CPT®/Medicare conflicts when counting HPI elements. You could be losing out o... Read more
3 Tips Connect the Correct Screening Diagnosis to Your Colonoscopy Code
Retain your V-codes even if the screening turns diagnostic. You should be following th... Read more
Keep Up Your Pace with ICD-10 Preparations
Whether you’ve been preparing or procrastinating, use the delay to get ahead of the ... Read more
Readers Question:
Mind Your Compliance Regulations Before Performing Gastric Emptying Scan
Question: My gastroenterologist wants to do a gastric emptying study in the office.... Read more
You Be the Coder:
Look Closely at the Final Path Report Before Coding a Polypectomy
Question: Should we wait for the final pathology report before coding a polypectomy... Read more
CPT® Coding Strategies:
Ensure Maximum Ablation Reimbursement With This Expert Advice
Hint: Watch for CCI bundling for multiple procedures involving other tumor removal metho... Read more
E/M Coding Update:
Maximize Your Success With Subsequent Hospital Care Codes Using These 5 Steps
Incorporating each of these steps into your coding might better your practice’s re... Read more
ICD-10 Update:
Enjoy Simple Transition to K65.1 For Peritoneal Abscess Diagnosis
Hint: Don’t forget to identify the etiology and report it separately. When your ... Read more
Reader Question:
Look Towards Subspecialty When Billing Consults Under Same Tax ID
Question: We are in a large GI group all under the same tax ID.  One of our ph... Read more
Reader Question:
Factor in Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app... Read more
Reader Question:
Understand "Calendar Date" to Avoid Coding Goof-ups
Question: The CPT® surgery guidelines state that the surgical package includes ... Read more
You Be the Coder:
Clear Confusion Over Reporting Different EGD Procedures by Different Clinicians
Question: Our pediatric gastroenterologist scheduled a patient for an EGD, coordina... Read more
CPT® Coding Strategies:
Conquer The Ins and Outs of Esophageal Dilations With This Expert Advice
Optimize payments by looking specifically for the use of fluoroscopy. If your clinicia... Read more
News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision.  Th... Read more
ICD-10 Update:
Rejoice For a One-to-One Simple Transition For Portal Hypertension
Hint: Don’t forget to check documentation for additional complications. When rep... Read more
Reader Question:
Avoid Modifier Confusion For Separate Colonoscopy Beyond Global Period
Question: Our physician did a colonoscopy on a patient back in August 2013 during w... Read more
Reader Question:
Get Clarification on Billing Consultation Codes For Established Patients
Question: Apatient was last seen by our PA on 10/21/11 for diarrhea and abdominal p... Read more
You Be the Coder:
Don't Forget Additional Codes When Reporting Lynch Syndrome Diagnosis
Question: I am looking for the diagnosis code for ‘Lynch Syndrome”, als... Read more
CCI 20.1 Update:
Get Set to Face Fresh Slew of Edits to Esophagoscopy, EGD and ERCP Codes
Don’t forget to check CCI when reporting multiple endoscopy procedures together. ... Read more
Enjoy a Smooth Transition on Your Way From ICD-9-CM to ICD-10
Get up-to-date expert tips from NGS to guide you. Entering into the new realm of submi... Read more
ICD-10 Update:
Go For a One-to-One Simple Transition to K28 ForGastrojejunal Ulcer
Hint: If cause is alcohol abuse, don’t forget to identify it additionally. When ... Read more
Reader Question:
Don't Forget to Check CCI Before Reporting Multiple ERCP Procedures
Question: Our physician performed multiple procedures on his patient, ‘43262&... Read more
Reader Question:
Base Hepatitis Screening Diagnosis Codes on Type of Risk Factors
Question: Can you let me know what the correct ICD-9 code for hepatitis screening t... Read more
You Be the Coder:
Use One Common HCPCS Code for Bacteriotherapy Irrespective of Payer
Question: I am looking at billing 44705 but I am not finding any RVUs for this code. F... Read more
CCI 20.0 Update:
Avoid Denials by Looking at CCI 20.0 When Reporting New EGD Codes
Look at CCI to see if the two ERCP procedures you are planning to report face bundling. ... Read more
Diagnosis Coding:
Delve Into Documentation to Confirm Diagnosis When Your Provider Fails to Pick One
Don’t hesitate to get back to your provider for details when you need them. You ... Read more
ICD-10 Update:
K56.3 Provides Simple One-to-one Transition For Gallstone Ileus
Hint: Distinguish from duodenal ileus to correctly nail the diagnosis. When you begin ... Read more
Reader Question:
Avoid Confusion About Diagnosis Codes For Screening Colonoscopies
Question: A patient who came in for colonoscopy has 1st degree family (mother) hist... Read more
Reader Question:
Get Clarification on Reporting Gastric Emptying Study
Question: My provider wants to do the gastric emptying study (78264) in the office. She ... Read more
Reader Question:
Avoid Location Based Assumption of Critical Care Codes
Question: After a patient with severe abdominal pain and hemoptysis in the ER was a... Read more
You Be the Coder:
Determine Patient Status For POS in Emergency Room
Question: Our physician was called to the ER to see a patient for dysphagia. He ass... Read more
CCI 20.0 Update:
Watch For Edits Bundling New Esophagoscopy Codes With Other Endoscopy Codes
Hint: Observe modifier indicator to see if you can unbundle the codes. While CPT® ... Read more
History How-To:
Point Your Provider in the Right Direction With These 5 History Tips
Beware of counting elements in more than one place. While recording patient history, y... Read more
ICD-10 Update:
K80.1 Offers Accurate Reporting Options For Cholelithiasis With Chronic Cholecystitis
Hint: Use different code sets when calculi are present in gall bladder and the biliary d... Read more
Reader Question:
Highlight These CCI Edits For Same Session Multiple Colonoscopic Procedures
Question: I code for an ASC and I often see situations where a colonoscopy is performed ... Read more
Reader Question:
Provide Entire Address, Not Generic Location in Block 32 of CMS-1500
Question: If you are billing home visits, 99341-99350, the place of service is 12. My qu... Read more
Reader Question:
Realize When to Use Modifiers For Unbundled CPT® Codes
Question: If I cannot find my two codes paired together in the CCI edits, how do I know ... Read more
You Be the Coder:
Get Clarified on DOS For Capsule Endoscopy
Question: In a previous issue of the “Gastroenterology Coding Alert” you hav... Read more
CPT® 2014 Update:
Simplify Your ERCP Stent Reporting With New Comprehensive Codes
Hint: Don’t forget to report other procedures performed such as stone or debris re... Read more
News You Can Use:
These E/M Coding Errors Could be Tripping Up Your Claims
CMS finds 14.0 percent improper E/M payment rate. If the 2012 Medicare Fee-for-Service... Read more
ICD-10 Update:
K57 Expands To 10 Options For Accurate Diverticulitis Reporting
Hint: Choose from another additional four codes if anatomical location is not specified.... Read more
Reader Question:
Understand When to Report CPT® Codes For Screening Colonoscopies
Question: When billing a screening colonoscopy for a high risk Medicare patient, what co... Read more
Reader Question:
Base Reduced Service Code on Original Intent
Question: My doctor did an incomplete colonoscopy and I’m not sure how to code it.... Read more
Reader Question:
Choose Appropriate Code For Same Day Admission and Discharge
Question: One of our physicians admitted a patient to the hospital at 10:30 a.m., and la... Read more
You Be the Coder:
Determine EGD Code By Procedure Intent
Question: Our gastroenterologist recently performed an EGD on a Medicare patient that wa... Read more